Quick Answer: Women's heart attack symptoms often differ from men's. While chest pain is still the most common symptom, many women experience jaw pain, unusual fatigue, shortness of breath, nausea, or back pain instead — and often dismiss these signs as the flu, stress, or heartburn. If something feels wrong, call 911 immediately.
Key Takeaways:
- Heart disease kills more women than all cancers combined, causing 1 in 5 female deaths.
- Only 44% of women recognize heart disease as their #1 killer.
- 30% of women having heart attacks experience no chest pain at all.
- Women wait an average of 54 hours to seek treatment vs. 16 hours for men.
- Women are more likely to attribute symptoms to non-life-threatening conditions like reflux, flu, or anxiety.
- "Time is muscle" — the sooner you get treatment, the less heart damage occurs.
When you picture someone having a heart attack, you probably imagine intense chest pain, clutching the chest, and maybe breaking out in a cold sweat. And while chest pain is the most common symptom for both men and women, that's not always how heart attacks look in women.
Women often experience subtler symptoms that are easy to dismiss or attribute to something less serious. About 30% of women having heart attacks don't experience chest pain at all. Instead, they might feel extreme fatigue, jaw pain, nausea, or shortness of breath — symptoms that sound more like the flu than a life-threatening emergency.
"Women, especially younger women, are less likely to recognize they are having a heart attack," says Nina Asrani, M.D., a cardiologist and physician on the medical staff at Texas Health Heart and Vascular Specialists, a Texas Physicians Group practice. Women often blame symptoms on reflux, stress, or just "feeling off."
This misunderstanding is dangerous. Women wait an average of 54 hours to seek treatment for heart attack symptoms, compared to just 16 hours for men. And every minute counts when it comes to heart attacks.
Why Heart Attack Symptoms Differ in Women
Heart attacks happen when blood flow to the heart is blocked, usually by plaque buildup in the coronary arteries. Women's hearts and blood vessels are structured differently than men's — smaller and more prone to microvascular disease (blockages in smaller blood vessels) — which affects how symptoms present.
Add to this the fact that heart disease research has historically focused on men, and you have a perfect storm: women experiencing atypical symptoms that even healthcare providers sometimes miss or misinterpret.
6 Warning Signs Women Often Miss
1. Unusual Fatigue That Won't Go Away
About 70% of women report experiencing unusual fatigue in the weeks before a heart attack. This isn't your typical end-of-day tiredness — it's profound exhaustion that comes on suddenly and makes even simple tasks feel overwhelming.
You might feel completely drained after activities that normally wouldn't tire you out, like climbing stairs, carrying groceries, or making the bed. Some women describe feeling like they're "walking through mud."
Why women miss it: Fatigue is easy to blame on busy schedules, poor sleep, stress, or just getting older. Women often push through exhaustion rather than recognizing it as a warning sign.
2. Jaw, Neck, or Shoulder Pain
According to the American Heart Association (AHA), many women experience an aching or pain in the jaw, neck, throat, or between the shoulder blades during a heart attack. The pain might come and go, or it might be constant.
"Symptoms of heart attack in women can present as chest pain but many times it can also present with other symptoms such as shortness of breath, neck or jaw pain, unusual fatigue or frequent indigestion," explains Brandie Williams, M.D., a cardiologist and physician on the medical staff at Texas Health Heart and Vascular Specialists, a Texas Physicians Group practice.
Why women miss it: Jaw or neck pain sounds like a dental problem, tension headache, or muscle strain from sleeping wrong. Without chest pain accompanying it, women rarely connect these symptoms to their heart.
3. Shortness of Breath
Feeling breathless without exertion, or becoming short of breath from activities that normally don't cause you to be winded, is a common warning sign. Some women feel short of breath when lying down but better when sitting upright.
This breathlessness often occurs with or without chest discomfort and may be accompanied by feeling lightheaded or dizzy.
Why women miss it: Women attribute breathlessness to being out of shape, anxiety, or panic attacks. If you're experiencing unexplained shortness of breath — especially with any other symptoms on this list — take it seriously.
4. Nausea, Indigestion, or Stomach Pain
Women are significantly more likely than men to experience nausea, vomiting, or indigestion during a heart attack. Some women feel pressure or pain in the upper abdomen that feels like severe heartburn or a stomach bug.
Why women miss it: These symptoms may signal "stomach problem" or "food poisoning" — not a heart attack. Women often take antacids and wait for symptoms to pass, losing critical treatment time.
5. Breaking Out in a Cold Sweat
Sudden sweating with no clear cause, especially cold, clammy sweating that comes with chest discomfort or other symptoms, can signal a heart attack. This isn't the kind of sweating you get from exercise or being overheated; it feels different and comes on suddenly.
Why women miss it: Hot flashes and night sweats are so common for women (especially during perimenopause and menopause) that they dismiss unusual sweating as hormonal rather than cardiac.
6. Chest Discomfort (But Not Always "Pain")
While chest pain is still the most common heart attack symptom in women, about 70% of women experience it — but many don't recognize it as such because it doesn't match what they expect.
Women often describe chest symptoms as:
- Pressure, squeezing, or fullness in the center of the chest
- Tightness or an uncomfortable ache rather than sharp pain
- A sensation like a rope being tied around the chest
- Burning or heaviness
The discomfort may last more than a few minutes, or it may come and go.
Why women miss it: If you're expecting dramatic, crushing chest pain like you've seen in movies, moderate pressure or tightness might not seem serious enough to be a heart attack.
When to Call 911
If you experience any of these warning signs — especially if you have more than one, or if symptoms come on suddenly — call 911 immediately. Don't drive yourself to the hospital. Don't wait to see if symptoms go away. Don't worry about "overreacting" or "bothering anyone."
Call 911 if you experience:
- Any chest discomfort, pressure, or pain (even if it's mild)
- Shortness of breath with or without chest discomfort
- Pain or discomfort in the arms, back, neck, jaw, or stomach
- Breaking out in a cold sweat
- Nausea or lightheadedness
- Unusual or extreme fatigue
Important: Women are more likely to experience a combination of symptoms rather than one obvious sign. If something feels off or wrong, even if you can't pinpoint why, trust your instincts.
Why Women Wait (And Why You Shouldn't)
Research shows women delay seeking treatment because they don't recognize symptoms as heart-related, minimize what they're feeling, don't want to "bother" anyone, or are too busy caring for others.
But heart attacks are medical emergencies. Every minute matters. Treatment works best when given within the first hour of symptoms starting. "Time is muscle" — the longer you wait, the more heart muscle dies and the higher your risk of serious complications.
Know Your Risk
Certain factors put women at higher risk for heart disease:
- High blood pressure (affects 46% of U.S. women)
- High cholesterol
- Diabetes (doubles your heart attack risk)
- Smoking
- Being overweight or obese
- Family history of early heart disease
- Age (risk increases after menopause)
- Pregnancy complications (gestational diabetes, preeclampsia)
- Autoimmune diseases
- Chronic stress
If you have any of these risk factors, talk to your Texas Health Physicians Group primary care physician about prevention strategies. Knowing your numbers — blood pressure, cholesterol, blood sugar — empowers you to take control of your heart health.
The Good News: Heart Disease Is Preventable
About 80% of heart disease is preventable through lifestyle changes. You can significantly reduce your risk by not smoking, eating a heart-healthy diet, getting regular physical activity (at least 150 minutes per week), maintaining a healthy weight, managing stress, and controlling blood pressure, cholesterol, and blood sugar.
"Heart disease is so common in women and it is preventable, so it is very important that women know their numbers," Williams emphasizes. "Those numbers include blood pressure, blood sugar, cholesterol and body mass index. By knowing and better controlling these numbers you can prevent heart disease."
Bottom Line
Heart disease is the #1 killer of women — but most women don't know it. And when women do have heart attacks, they often don't recognize the symptoms because they're expecting chest pain when their bodies are signaling distress in completely different ways.
Trust your body. If something feels wrong, don't dismiss it.
Texas Health offers comprehensive cardiac care throughout Dallas-Fort Worth, including prevention, diagnosis, and treatment of heart disease. Board-certified cardiologists work with you to assess your risk, develop prevention strategies, and provide expert care if you've experienced a heart attack.
If you're concerned about your heart health, take the Heart Health Assessment to understand your risk factors.
Sources:
- CDC: About Women and Heart Disease.
- Harvard Health: The Heart Disease Gender Gap.
- Harvard Health: Understanding the heart attack gender gap.
- American Journal of Cardiology: Gender differences in symptom presentation associated with coronary heart disease.
- Temple Health: Heart Attack Symptoms in Men vs. Women: Key Differences.
- Medical News Today: Heart attack in women: 8 symptoms and risk factors.
- American Heart Association: Heart Attack Symptoms in Women.